Summary: Researchers found that intracranial hemorrhage, or “cerebral hemorrhage,” doubles the risk of developing dementia in later years. Thrombus-induced ischemic stroke has long been associated with cognitive decline, but this study shows that bleeding also significantly increases the risk of dementia.
Using Medicare data from around 15,000 patients, scientists observed a double increase in dementia diagnosis within about 5.6 years of brain bleeding. Findings suggest that bleeding can cause dementia via amyloid beta accumulation or may result from shared risk factors such as chronic vascular damage.
Given these insights, researchers emphasize the importance of regular cognitive screening in patients who have experienced bleeding. Future research will investigate the underlying mechanisms and evaluate the safety of Alzheimer’s disease treatment in these patients.
Important facts
Increased risk of dementia: Intracranial bleeding doubles the risk of developing dementia within a few years. Possible Causes: Bleeding can cause dementia via amyloid beta accumulation with neurodegenerative diseases. Clinical impact: Patients with cerebral hemorrhage should be monitored for reduced awareness. Treatment of Alzheimer’s disease may require reevaluation in this group.
Source: Weill Cornell University
Researchers at Weill Cornell Medicine have found that “cerebral hemorrhage” caused by intracranial hemorrhage or ruptured blood vessels in the brain doubles the risk for people who develop dementia later in life.
The relationship between dementia and ischemic stroke caused by thrombosis blocking the blood supply to the brain has attracted more attention, but a new study published on stroke on January 30th has revealed previous findings It expands to bleeding.
“Weii Cornell Medicine’s Assistant Professor of Neurology and a neurologist at Newyork-Presbyterian/Weill Cornell Medical Center,” said first author, Dr. Samuel Bruce, assistant professor of neurology at Weill Cornell Medicine and neurologist at Newyork-Presbyterian/Weill Cornell Medical Center.
This suggests that people who have experienced intracranial hemorrhage should be screened regularly for cognitive impairment, as the outcome can inform future care decisions for patients and their families.
Using Medicare insurance claims from 2008 to 2018, Dr. Bruce and his colleagues evaluated approximately 15,000 people with different types of intracranial bleeding. Although bleeding can occur after head trauma, researchers focused on spontaneous occurrences.
They observed a two-fold increase in the incidence of first dementia diagnosis in these patients, compared with over 2 million people who had not bleeding, averaged 5. Within 6 years, they observed a two-fold increase in the incidence of first dementia diagnosis. .
Results are added to literature from other labs showing that bleeding is related to later cognitive problems.
For example, a study based on Danish medical records showed that 11.5% of people who developed dementia after a blood vessel ruptured in the brain had an approximately 2.5-fold increase over the general population. On the other hand, ischemic strokes, usually caused by thrombosis, increased the risk of dementia by about 1.7 times.
“Why does intracranial bleeding increase the risk of dementia? Senior author Dr. Santosh Murthy, PhD, associate professor of neurology at the Feil Family Brain & Mind Research Institute and Weill Cornell Medicine.
Hemorrhage can directly cause dementia, which can destroy brain function by causing the accumulation of a protein called amyloid beta in the brain and its blood vessels. Alternatively, bleeding and dementia can be indirectly connected, as the same factors reduce the risk of both conditions, such as chronic damage to blood vessels in the brain.
“We really need to consider the meaning of dementia because we see more evidence that dementia can follow bleeding,” says Mercy, a neurologist at the New York Presbyterian/Weil Cornell Medical Center. The doctor said.
“Evaluating the safety of anti-amyloid beta treatments for Alzheimer’s disease in people who have experienced bleeding, for example, should be a research priority.”
Researchers explore how bleeding contributes to different subtypes of dementia, as new treatments developed for intracranial hemorrhage could ultimately lead to patients who live longer after development. We concluded that further research is needed.
About this neurology research news
Author: Barbara Prempeh
Source: Weill Cornell University
Contact: Barbara Prempeh – Weill Cornell University
Image: Image credited to Neuroscience News
Original Research: Closed Access.
“Atraumatic intracranial hemorrhage and the risk of dementia among US Medicare beneficiaries,” Samuel Bruce et al. stroke
Abstract
Risk of atraumatic intracranial hemorrhage and dementia in US Medicare beneficiaries
background:
To study the risk of developing dementia after atraumatic intracranial hemorrhage in a diverse US population and to assess whether this risk of intracranial hemorrhage is different for subtypes of intracranial hemorrhage.
method:
A retrospective cohort study was conducted using both inpatient and outpatient claims data on Medicare beneficiaries from January 1, 2008 to December 31, 2018.
Exposure was a new diagnosis of atraumatic intracranial hemorrhage, defined as the combination of intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and subarachnoid hemorrhage (SDH). The result was my first diagnosis of dementia. Exposures and results were identified using validated ICD-9 and ICD-10-CM diagnostic codes.
We excluded patients with prevalent intracranial hemorrhage or dementia so that only incoming cases were counted in the analysis. In the primary analysis, Cox regression was used to study the risk of dementia after intracranial hemorrhage after adjusting for demographics and comorbidities.
Secondary analysis investigated the risk of dementia in different subtypes of intracranial hemorrhage.
result:
Of the 2.1 million patients, 14,775 were diagnosed with intracranial hemorrhage. 5. During follow-up in 6 years (IQR, 3.0-9.1), incident dementia was diagnosed in 2527 (17.1%) patients with intracranial hemorrhage and 260,691 (12.8%) without intracranial hemorrhage.
The cumulative incidence of dementia was 8.6% of patients with intracranial hemorrhage (IQR, 8.1-8.9) and 2.2% of patients without intracranial hemorrhage (2.0-2.4).
In adjusted COX regression analysis, intracranial hemorrhage was associated with an increased risk of developing dementia (HR, 2.0; CI, 1.9-2.2). Secondary analysis showed that ICH (HR, 2.4; CI, 2.2-2.5), SAH (HR, 1.99; CI, 1.7-2.2), and SDH (HR, 1.6; CI, 1.4– High was observed. 1.7).
Conclusion:
In a large, heterogeneous cohort of older US participants, intracranial hemorrhage was independently associated with a double-fold increased risk of developing dementia. This increased risk was observed consistently across intracranial hemorrhage subtypes.
